[Congressional Record Volume 145, Number 23 (Tuesday, February 9, 1999)]
[Extensions of Remarks]
[Page E172]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 INTRODUCTION OF THE MEDIGAP ACCESS PROTECTION FOR SENIORS ACT OF 1999

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                        HON. BENJAMIN L. CARDIN

                              of maryland

                    in the house of representatives

                       Tuesday, February 9, 1999

  Mr. CARDIN. Mr. Speaker, I rise today to introduce legislation that 
will restore to thousands of our nation's seniors access to an 
essential element of comprehensive medical care--prescription drugs.
  Prescription drugs are the single largest out-of-pocket medical 
expense for the elderly, and for many the greatest cause for worry. To 
secure prescription drug coverage, as well as other benefits not part 
of the basic Medicare package, many seniors have chosen to join HMOs 
during the past few years.
  But October 2, 1998 signaled a turning point for them. You may recall 
that was the deadline for HMOs to notify the Health Care Financing 
Administration whether they would continue to participate in 
Medicare+Choice in 1999. Well, more than 100 plans nationwide decided 
to either end their participation with Medicare entirely, or to cut 
back their service areas. As a result, 440,000 Medicare HMO enrollees 
in 22 states were abandoned by their Medicare HMO.
  More than 300,000 Medicare beneficiaries had a prescription drug 
benefit and lost it on December 31st. More than 70,000 beneficiaries 
were left with no Medicare HMO option whatsoever. Not only has the 
number of plans offering the drug benefit shrunk considerably from last 
year, it is expected to be even lower when HMOs submit their proposals 
to HCFA for next year.
  Although Congress' stated goal in the Balanced Budget Act was to 
provide more choices to seniors, it seems that the reverse has 
happened. BBA did provide some security for seniors whose Medicare HMOs 
abandon them--they are guaranteed the ability to enroll in four of the 
ten standardized Medigap plans: A, B, C, or F. But none of those plans 
offers any prescription drug coverage. They can apply for one of the 
plans that offers it: H, I, or J, but insurance companies can refuse to 
enroll them, place pre-existing conditions on those policies, or 
discriminate in pricing because of the patient's health status, 
effectively denying them access.
  In the closing days of the 105th Congress, I introduced the Medigap 
Access Protection for Seniors Act. This bill helps beneficiaries 
maintain their outpatient drug coverage when they are dropped from a 
Medicare HMO that provided that benefit, by guaranteeing them 
enrollment in plans supplemental plan H. I, or J.
  Today, I am reintroducing this legislation. Seniors across the nation 
placed their trust in Congress when they selected a Medicare HMO. They 
did so because of the promise of additional benefits, little or no 
additional premium costs, and with the belief that these plans would 
remain accessible to them. In doing so, many gave up their supplemental 
policies. Now, they can only return to the most limited of Medigap 
plans, ones with no coverage for prescription drugs.
  Mr. Speaker, I am calling upon my colleagues to join me in taking 
this important step to restore prescription drug benefits for thousands 
of beneficiaries and I am calling upon this Congress to pass this bill 
early in the first session and renew seniors' faith in the promise of 
Medicare.

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